Shin Danny, Gill Simone V, Kim Theresa W, Magane Kara M, Mason Tiana, Heeren Timothy, Winter Michael, Helfrich Christine, Saitz Richard
Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA.
Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Subst Abuse. 2022 Dec 23;16:11782218221145548. doi: 10.1177/11782218221145548. eCollection 2022.
People living with HIV (PLWH) are at risk for falls due to polypharmacy, unhealthy substance (risky alcohol and/or illicit drug) use, low physical activity, and frailty combined with typical age-related physical changes. Fall prevention is needed to reduce the morbidity related to falls and fractures, however, there is a paucity of data on the design of a fall prevention intervention and whether it can be delivered virtually. We describe the protocol of a pilot randomized trial of a virtual occupational therapy fall prevention intervention for people with HIV at high risk for falls and recent alcohol and/or drug use.
PLWH will be recruited from the Boston ARCH 4F Cohort study, an observational study of PLWH to examine the impact of alcohol on falls. Trial participants will be randomized to either an occupational therapy-led fall prevention intervention or provided with written education about fall prevention and alcohol use (control). The 10-week fall prevention intervention was based upon results from qualitative interviews with PLWH about falls and will consist of weekly virtual group sessions, home exercises and phone-check-ins, delivered by occupational therapists. The primary outcome measures will be number of groups attended and a participant-completed satisfaction survey. Change in number of falls, alcohol and other drug use, and physical functioning will be examined.
A virtual occupational therapy fall prevention intervention addresses the emerging concern of fall risk in PLWH and alcohol use. This pilot study will provide preliminary estimates of fall-related outcomes as well as feasibility of study procedures for a larger trial.
NCT04804579. Boston University Protocol Record H-41041.
由于多重用药、不健康物质（高风险饮酒和/或非法药物）使用、低体力活动以及与年龄相关的典型身体变化相结合导致的身体虚弱，感染艾滋病毒的人（PLWH）有跌倒风险。需要采取预防跌倒措施以降低与跌倒和骨折相关的发病率，然而，关于预防跌倒干预措施的设计及其是否可以通过虚拟方式实施的数据很少。我们描述了一项针对有跌倒高风险且近期有饮酒和/或药物使用情况的艾滋病毒感染者进行虚拟职业治疗预防跌倒干预的试点随机试验方案。
将从波士顿ARCH 4F队列研究中招募PLWH，该研究是一项关于PLWH的观察性研究，旨在研究酒精对跌倒的影响。试验参与者将被随机分为接受职业治疗主导的预防跌倒干预组或接受关于预防跌倒和酒精使用的书面教育组（对照组）。为期10周的预防跌倒干预基于对PLWH关于跌倒的定性访谈结果，将包括由职业治疗师提供的每周虚拟小组会议、家庭锻炼和电话随访。主要结局指标将是参加的小组数量和参与者完成的满意度调查。将检查跌倒次数、酒精和其他药物使用情况以及身体功能的变化。
虚拟职业治疗预防跌倒干预解决了PLWH跌倒风险和酒精使用这一新兴问题。这项试点研究将提供与跌倒相关结局的初步估计以及更大规模试验的研究程序可行性。
NCT04804579。波士顿大学方案记录H-41041。
